Incidence of serious respiratory tract infections and associated characteristics in a population exposed to immunosuppressive therapies: a register-based population study.
Autor: | Etienne C; Service de Médecine Interne, APHP, Hôpital Ambroise Paré, Université de Versailles Saint-Quentin-en-Yvelines, 9 Av. Charles de Gaulle, Boulogne-Billancourt, 92100, France. cindy.etienne@aphp.fr., Vilcu AM; Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP), Inserm, Sorbonne Université, Paris, France., Finet F; Service de Médecine Interne, APHP, Hôpital Ambroise Paré, Université de Versailles Saint-Quentin-en-Yvelines, 9 Av. Charles de Gaulle, Boulogne-Billancourt, 92100, France., Chawki S; Service de Maladies Infectieuses, APHP, Hôpital Lariboisière, Université Paris Cité, Paris, France., Blanchon T; Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP), Inserm, Sorbonne Université, Paris, France., Steichen O; Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP), Inserm, Sorbonne Université, Paris, France.; Service de Médecine Interne, Hôpital Tenon, APHP, Sorbonne Université, Paris, France., Hanslik T; Service de Médecine Interne, APHP, Hôpital Ambroise Paré, Université de Versailles Saint-Quentin-en-Yvelines, 9 Av. Charles de Gaulle, Boulogne-Billancourt, 92100, France. thomas.hanslik@aphp.fr.; Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP), Inserm, Sorbonne Université, Paris, France. thomas.hanslik@aphp.fr. |
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Jazyk: | angličtina |
Zdroj: | BMC infectious diseases [BMC Infect Dis] 2024 Oct 21; Vol. 24 (1), pp. 1184. Date of Electronic Publication: 2024 Oct 21. |
DOI: | 10.1186/s12879-024-10039-2 |
Abstrakt: | Background: Immunosuppressive therapies are associated with a risk of infections. Nevertheless, their incidence in this population remains unclear. This study aims to determine the incidence of serious respiratory tract infections (SRI) in a population exposed to immunosuppressive therapies. Methods: Data from a representative sample of the French healthcare claims from 01/01/2014 to 12/31/2019 were analyzed. Exposure to immunosuppressive therapy was defined by the dispensation of drugs through community pharmacies or in hospitals. SRI diagnosis was based on ICD-10 codes from hospitalization records. A cohort analysis was performed to estimate standardized SRI incidence rates. A nested case-control analysis within this cohort was used to study the characteristics associated with SRI. Results: We identified 24,122 individuals exposed to immunosuppressive therapies, among which 1,559 developed SRI, resulting in a standardized incidence rate of 1,398 per 100,000 person-years. In this population, the risk of SRI was associated with a history of cancer (OR 2.68, 95% Confidence Intervals (CI) 2.24-3.21; p < 0.001), chronic respiratory disease (2.62, 95%CI 2.17-3.16; p < 0.001), end-stage renal failure (2.38, 95%CI 1.37-4.13; p = 0.003), neurodegenerative diseases (1.52, 95%CI 1.07-2.17; p = 0.026), diabetes (1.44, 95%CI 1.14-1.82; p < 0.001), psychiatric diseases (1.27, 95%CI 1.06-1.52; p < 0.001), and cardiovascular diseases (1.26, 95%CI 1.04-1.52; p = 0.002). Compared to corticosteroids alone, the risk of SRI was lower in individuals treated with conventional synthetic disease-modifying anti-rheumatic drugs (csDMARD) only (0.44, 95%CI 0.25-0.78; p < 0.001). Conclusion: In the population exposed to immunosuppressive therapies, a history of chronic disease is associated with an increased risk of SRI. This risk is lower in those receiving csDMARD alone than corticosteroids alone. (© 2024. The Author(s).) |
Databáze: | MEDLINE |
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